TY - JOUR
T1 - Sedation depth during spinal anesthesia and survival in elderly patients undergoing hip fracture repair
AU - Brown, Charles
AU - Azman, Andrew S.
AU - Gottschalk, Allan
AU - Mears, Simon C.
AU - Sieber, Frederick E.
N1 - Publisher Copyright:
Copyright © 2014 International Anesthesia Research Society.
PY - 2014
Y1 - 2014
N2 - Low intraoperative Bispectral Index (BIS) values may be associated with increased mortality. In a previously reported trial to prevent delirium, we randomized patients undergoing hip fracture repair under spinal anesthesia to light (BIS >80) or deep (BIS approximately 50) sedation. We analyzed survival of patients in the original trial. Among all patients, mortality was equivalent across sedation groups. However, among patients with serious comorbidities (Charlson score >4), 1-year mortality was reduced in the light (22.2%) vs deep (43.6%) sedation group (hazard ratio [HR], 0.43; 95% confidence interval, 0.19-0.97; P = 0.04) during spinal anesthesia. Similarly, among patients with Charlson score >6, 1-year mortality was reduced in the light (28.6%) vs deep (52.6%) sedation group (HR 0.33; 95% confidence interval, 0.12-0.94; P = 0.04) during spinal anesthesia. Further research on reduced mortality after light sedation during spinal anesthesia is needed.
AB - Low intraoperative Bispectral Index (BIS) values may be associated with increased mortality. In a previously reported trial to prevent delirium, we randomized patients undergoing hip fracture repair under spinal anesthesia to light (BIS >80) or deep (BIS approximately 50) sedation. We analyzed survival of patients in the original trial. Among all patients, mortality was equivalent across sedation groups. However, among patients with serious comorbidities (Charlson score >4), 1-year mortality was reduced in the light (22.2%) vs deep (43.6%) sedation group (hazard ratio [HR], 0.43; 95% confidence interval, 0.19-0.97; P = 0.04) during spinal anesthesia. Similarly, among patients with Charlson score >6, 1-year mortality was reduced in the light (28.6%) vs deep (52.6%) sedation group (HR 0.33; 95% confidence interval, 0.12-0.94; P = 0.04) during spinal anesthesia. Further research on reduced mortality after light sedation during spinal anesthesia is needed.
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U2 - 10.1213/ANE.0000000000000157
DO - 10.1213/ANE.0000000000000157
M3 - Article
C2 - 24781567
AN - SCOPUS:84902155316
SN - 0003-2999
VL - 118
SP - 977
EP - 980
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 5
ER -